Abstract
The endoscopic endonasal transsphenoidal approach has been proposed in the past decade
as a minimally invasive surgical technique for the removal of pituitary tumors. From
January 1997 to November 1999, 100 consecutive patients with pituitary tumors underwent
endoscopic endonasal surgery, according to Jho's technique. We employed 0°, 30°, 45°,
and 70° rigid endoscopes, 18 - 30 cm in length, 4 mm in diameter with an outer sleeve
for irrigation and secured to a holder. Among the 87 pituitary adenomas, tumor removal
was total in 51, subtotal (> 80 %) in 20 and partial in 16 cases. Four craniopharyngiomas
were totally removed and an intra-suprasellar arachnoid cyst was emptied; a biopsy
was performed in the two patients with a clivus chordoma. The two cases of sphenoid
sinusitis were cured by surgery, the three patients with spontaneous CSF rhinorrhea
were successfully treated and the residual nasal meningocele was removed. The endoscopic
endonasal transsphenoidal approach appeared to be less traumatic than the traditional
microsurgical approach, was very effective, and was characterized by a reduced number
of complications. However, the relatively small series together with the short follow-up
do not allow us to draw definitive conclusions. The post-operative reduction in hospital
stay (two days in 40 of 100), significantly reduced the cost of patient's management.
Key words
Endoscopic Endonasal Surgery - Pituitary Adenoma - Transsphenoidal Surgery - Endoscopy
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P. Cappabianca,M.D.
Department of Neurosurgery · “Federico II” University
Via Pansini 5
80131 Naples
Italy
Telefon: +39-081-7462583
Fax: +39-081-7462497; +39-081-5987821
eMail: cappabia@unina.it
